E-Posters-Factors that Predict the Severity of Pelvic Organ Prolapse

Factors that Predict the Severity of Pelvic Organ Prolapse - Taylor XY Lim

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Pelvic organ prolapse (POP) is a common condition that affects many women. However, there is still a lack of understanding about the risk factors that predict the severity of the disease. This study aimed to identify these risk factors to guide better patient management.<br /><br />The study included 736 women who underwent vaginal hysterectomy at a hospital in Singapore from 2007 to 2011. The severity of POP was assessed using the Baden-Walker Halfway Scoring System. Several variables were investigated, including menopausal status, body mass index (BMI), occupational manual labor, parity, mode of delivery, race, and previous pelvic surgeries.<br /><br />The results of the study revealed several important findings. Menopause was found to be the strongest predictive factor for severe POP. Estrogen deficiency during menopause can decrease pelvic support, leading to more severe prolapse. The study also found that a BMI of ≥25 and occupational manual labor were the most preventable risk factors for severe POP. Chronic strain and increased abdominal pressure from these factors weaken the pelvic floor muscles. Weight loss and minimizing heavy lifting and prolonged standing were suggested as preventative measures.<br /><br />Increasing parity was associated with severe POP, but the mode of delivery (vaginal, forceps, or caesarean) did not have a significant impact. The pregnancy hormone relaxin may contribute to the structural changes that weaken connective tissues. Additionally, this study identified Malay race as an independent risk factor for severe POP. This may be due to higher parity and BMI, as well as lower education and income levels, leading to decreased health literacy and access to healthcare.<br /><br />Interestingly, previous pelvic surgeries for prolapse or incontinence were found to be protective against severe POP. This may be attributed to specific surgical techniques that reduce recurrence rates.<br /><br />In conclusion, women should maintain a BMI of <25, avoid manual labor, and be educated about the risks associated with menopause and Malay ethnicity to prevent severe POP. Early presentation for prolapse should be encouraged in high-risk patients. It is important to note that this study had certain limitations, such as being retrospective and not assessing symptomatic severity.<br /><br />Overall, this study provides valuable insights into the risk factors that predict the severity of pelvic organ prolapse, which can help guide patient management and improve outcomes.

Keywords

pelvic organ prolapse

risk factors

severity

patient management

menopause

BMI

occupational manual labor

parity

mode of delivery

previous pelvic surgeries